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Liverpool CCG Manages Referral Capacity and Workload in Primary Care via Flo

posted 22 Jan 2016, 09:51 by Philip O'Connell   [ updated 16 Oct 2017, 05:23 by Hollie O'Connell ]

NHS Liverpool 
Clinical Commissioning Group 
Sam McPartland 
Sharon Poll 


22 January 2016 


Liverpool CCG, via the MI Programme has successfully implemented Simple Telehealth for patient self-monitoring of blood pressure targeting people at risk of hypertension to support efficient diagnosis or exclusion.  

Three different pathways incorporating Flo have been established designed by Sam McPartland and Sharon Poll, including direct referral and monitoring by the GP practice, by Health Trainers and monitoring through the telehealth hub in conjunction with Philips Motiva (see Fig. 1 below).

Evaluation over a 6-month period revealed that patients reported feeling more in control of their health, more motivated to improve their health and had an increased awareness of their blood pressure. 95.6% of patients reported that they would recommend Flo to their family and friends with 94.8% preferring to send readings via Flo than go into the practice demonstrating patient acceptance.

To underpin the success, the CCG’s Clinical Reference Group’s agreed to a new management plan, and GP surgeries were engaged with supporting pathways established to manage referral capacity and expected workload.

The Health Trainers received training from Informatics Merseyside who also developed an e-learning package
 for Simple Telehealth aimed at primary care staff for the practices that wished to administer their own Simple Telehealth Programme (pathway one). Along with user notes and a user guide, it shows and instructs how to add a patient, add the appropriate protocol, transfer and discharge a patient. It will also be a useful resource for the Health Trainers when going through the same process for adding and discharging a patient using Flo. It is in the form of a “Punch Presentation” – a type of software that enables the user to work step-by- step and interactively, effectively mirroring a classroom based session.

Involving community-based staff added value to Mi’s Simple Telehealth agenda. By instigating Simple Telehealth through Health Trainers, Mi has been able to exploit a series of systemic advantages. These include: 


  • Providing direct access to primary care settings and their patients - as Health Trainers already provide
an effective service in many surgeries across
the city, they are well-placed to contact General Practice leads, promote Flo with them and secure GP referrals to Simple Telehealth - three-quarters of referrals to the core health trainer service come from GP settings;
  • Combining Simple Telehealth with the pre-existing Health Trainers’ approach is attractive to GP practices - as hypertension is a priority area
for many GP’s and supporting people to make positive lifestyle and well-being choices that can impact on their blood pressure levels meets CCG neighbourhood priorities and key performance indicators; 
  • Combining Flo, Health Trainer preventative support and a person centred approach provides a multi- disciplinary holistic approach to health improvement aided by the use of technology; 
  • Enabling greater integration with other community referrals, due to the Health Trainers extensive networks and knowledge of the city and their comprehensive links with health, social and well- being services in the city; 
  • The opportunity to link the roll out of Flo with other PSS services - such as its befriending services, which provide social support and address social isolation. 

Plans are underway to broaden the scope of use within the CCG to include blood pressure management post diagnosis and for Liverpool Community health Services to use Flo as part of their telehealth offering to patients with COPD.





For further information contact lisa.taylor@simple.uk.net



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